Benefily
Sign inCreate account

Does Medicare Part D cover Matzim?

Matzim appears on the Medicare Part D formularies of 167 payers in the corpus, across 3,198 plans. 0 payers require prior authorization on every covering plan, 0 on some plans, and 167 on none.

Prior authorization is set per plan, not per payer. Pick a payer below for its full plan-by-plan breakdown, effective 2026-06-30.

Coverage by payer

PayerPlans coveringRequire prior authStep therapyQuantity limitStatus
UnitedHealthcare697000No prior authorization
Aetna (CVS Health)646000No prior authorization
Cigna171000No prior authorization
Centene (WellCare)163000No prior authorization
Devoted Health132000No prior authorization
Blue Cross Blue Shield (affiliate)89000No prior authorization
Alignment Healthcare67000No prior authorization
Elevance Health (Anthem)64000No prior authorization
Medco Containment Life And Medco Containment Ny60000No prior authorization
Molina Healthcare51000No prior authorization
Simply Healthcare Plans, INC.50000No prior authorization
Uhc Of California40000No prior authorization
Bravo Health Pennsylvania, INC.35000No prior authorization
Preferred Care Partners, INC.35000No prior authorization
Solis Health Plans, INC.24000No prior authorization
Sunshine State Health Plan, INC.24000No prior authorization
Capital Advantage Insurance Company23000No prior authorization
Physicians Health Choice Of Texas, LLC22000No prior authorization
Tufts Associated Health Maintenance Organization21000No prior authorization
Mmm Healthcare, LLC20000No prior authorization
Health Care Service Corporation19000No prior authorization
Harmony Health Plan, INC.19000No prior authorization
Medica Health Plans17000No prior authorization
Upmc Health Plan, INC.17000No prior authorization
Bluecross Blueshield Of Tennessee, INC.17000No prior authorization
California Physicians' Service16000No prior authorization
Excellus Health Plan, INC.16000No prior authorization
Medical Mutual Of Ohio16000No prior authorization
Superior Healthplan, INC.15000No prior authorization
Central Health Plan Of California, INC.15000No prior authorization
Selecthealth, INC.14000No prior authorization
Peoples Health, INC.13000No prior authorization
Clover Health13000No prior authorization
Healthsun Health Plans, INC.13000No prior authorization
Upmc Health Network, INC.12000No prior authorization
HMO Louisiana, INC.12000No prior authorization
Hcsc Insurance Services Company11000No prior authorization
Wellpoint Texas, INC.11000No prior authorization
Mount Carmel Health Plan, INC.11000No prior authorization
Pacificsource Community Health Plans11000No prior authorization
Wellpoint Insurance Company11000No prior authorization
Community Insurance Company10000No prior authorization
Quartz Health Plan Corporation10000No prior authorization
Compcare Health Services Insurance Corporation10000No prior authorization
Sanford Health Plan9000No prior authorization
Allina Health And Aetna Insurance Company9000No prior authorization
Doctors Healthcare Plans, INC.9000No prior authorization
New York Quality Healthcare Corporation9000No prior authorization
Wellpoint Tennessee, INC.9000No prior authorization
Meridian Health Plan Of Michigan, INC.8000No prior authorization
American Progressive Life & Hlth Ins Company Of Ny8000No prior authorization
Keystone Health Plan East, INC.8000No prior authorization
Network Health Insurance Corporation8000No prior authorization
Fallon Community Health Plan8000No prior authorization
Health Partners Plans, INC.8000No prior authorization
Bravo Health Mid-Atlantic, INC.7000No prior authorization
Medica Insurance Company7000No prior authorization
Summacare INC.7000No prior authorization
Keystone Health Plan Central, INC.7000No prior authorization
Essence Healthcare PPO, INC.7000No prior authorization
Providence Health Assurance7000No prior authorization
Mass General Brigham Health Plan, INC6000No prior authorization
Buckeye Community Health Plan, INC.6000No prior authorization
Nebraska Total Care, INC.6000No prior authorization
Gold Kidney Of Florida INC6000No prior authorization
Essence Healthcare, INC.6000No prior authorization
Hometown Health Plan, INC.6000No prior authorization
Mvp Health Plan, INC.6000No prior authorization
Connecticare, INC.6000No prior authorization
Preferred Care Network, INC.6000No prior authorization
Scott And White Health Plan6000No prior authorization
Coordinated Care Of Washington, INC.5000No prior authorization
Viva Health, INC.5000No prior authorization
Coordinated Care Corporation5000No prior authorization
HMO Colorado, INC.5000No prior authorization
Gold Kidney Of Arizona5000No prior authorization
Martin'S Point Generations Advantage, INC.5000No prior authorization
Meridian Health Plan Of Illinois, INC.5000No prior authorization
Sunflower State Health Plan, INC.5000No prior authorization
Arkansas Health & Wellness Health Plan, INC.5000No prior authorization
Home State Health Plan, INC.4000No prior authorization
Baylor Scott & White Insurance Company4000No prior authorization
Care N' Care Insurance Company Of North Carolina4000No prior authorization
Pennsylvania Health & Wellness, INC.4000No prior authorization
Sapphire Edge, INC.4000No prior authorization
The Health Plan Of West Virginia, INC.4000No prior authorization
Qcc Insurance Company4000No prior authorization
Security Health Plan Of Wisconsin, INC.4000No prior authorization
Boston Medical Center Health Plan, INC.4000No prior authorization
Bluecross Blueshield Kansas Solutions, INC.4000No prior authorization
Thp Insurance Company4000No prior authorization
Amh Health, LLC4000No prior authorization
Quartz Health Plan Mn Corporation4000No prior authorization
Medisun, INC.3000No prior authorization
Wellpoint West Virginia , INC.3000No prior authorization
Louisiana Health Service & Indemnity Company3000No prior authorization
Eternalhealth, INC.3000No prior authorization
Partners Insurance Company INC3000No prior authorization
Mount Carmel Health Insurance Company3000No prior authorization
Community Care Health Plan Of Louisiana, INC.3000No prior authorization
Trillium Community Health Plan, INC.3000No prior authorization
Wellpoint New Jersey, INC.3000No prior authorization
Independent Health Association, INC.3000No prior authorization
Capital District Physicians' Health Plan, INC.3000No prior authorization
Eternalhealth Of Arizona INC3000No prior authorization
Mount Carmel Health Plan Of Idaho, INC.3000No prior authorization
Celtic Insurance Company3000No prior authorization
Amerihealth Insurance Company Of New Jersey3000No prior authorization
Central Mass Health, LLC3000No prior authorization
Bluecross And Blueshield Of South Carolina3000No prior authorization
Ghs Insurance Company3000No prior authorization
Managed Health Services Insurance CORP.3000No prior authorization
Medco Containment Life & Medco Containment Ny & Health Care3000No prior authorization
Hamaspik, INC.2000No prior authorization
Arizona Physicians Ipa, INC.2000No prior authorization
Carepartners Of Connecticut, INC.2000No prior authorization
Beshp, INC.2000No prior authorization
Wellpoint Iowa, INC.2000No prior authorization
Wellpoint Washington, INC.2000No prior authorization
Village Senior Services Corporation2000No prior authorization
Sentara Health Plans2000No prior authorization
Partners Insurance Company Of New Jersey INC2000No prior authorization
Sanford Health Plan Of Minnesota2000No prior authorization
Upmc For You, INC2000No prior authorization
Selectcare Of Texas, INC.2000No prior authorization
Banner - University Care Advantage2000No prior authorization
Tufts Health Public Plans, INC.2000No prior authorization
Vns Choice2000No prior authorization
Bridgeway Health Solutions Of Arizona, INC.2000No prior authorization
Community Health Plan Of Washington2000No prior authorization
Capital Health Plan2000No prior authorization
Senior Whole Health Of New York, INC.2000No prior authorization
Missouri Care, Incorporated2000No prior authorization
Elderserve Health, INC.2000No prior authorization
Good Samaritan Insurance Plan Of Nebraska, INC.2000No prior authorization
Excellus Health Plan Community Care LLC2000No prior authorization
Group Health Cooperative Of Eau Claire2000No prior authorization
Caresource Georgia CO.2000No prior authorization
Trinity Health Plan Of Michigan INC2000No prior authorization
Mount Carmel Health Plan Of New York, INC.2000No prior authorization
Longevity Health Plan Of New Jersey Insurance Comp2000No prior authorization
Hm Health Insurance Company2000No prior authorization
Longevity Health Plan Of Colorado, INC.1000No prior authorization
Metroplus Health Plan, INC.1000No prior authorization
Wellpoint Health Plans, INC.1000No prior authorization
Longevity Health Plan Of Florida, INC.1000No prior authorization
HMO Minnesota1000No prior authorization
Wellpoint South Carolina, INC.1000No prior authorization
Upper Peninsula Health Plan, LLC1000No prior authorization
Connecticare Insurance Company, INC.1000No prior authorization
Samaritan Health Plans, INC.1000No prior authorization
Ghs Health Maintenance Organization, INC.1000No prior authorization
Hap Caresource1000No prior authorization
Absolute Total Care, INC.1000No prior authorization
Longevity Health Plan Of North Carolina, INC.1000No prior authorization
Banner Health Plan, INC.1000No prior authorization
Aids Healthcare Foundation1000No prior authorization
Health Plan Of Careoregon, INC.1000No prior authorization
San Mateo Health Commission1000No prior authorization
Caresource Ohio, INC.1000No prior authorization
Upmc Health Coverage, INC.1000No prior authorization
Longevity Health Plan Of Michigan, INC.1000No prior authorization
Longevity Health Plan Of New York, INC.1000No prior authorization
Healthy Mississippi, INC.1000No prior authorization
Longevity Health Plan Of Illinois, INC.1000No prior authorization
Ventura County Medi-Cal Managed Care Commission1000No prior authorization
Horizon Insurance Company1000No prior authorization

“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Matzim product on its formulary carries that condition.

Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.